Bioterrorism and the Profession: If a Missile or a Disease Outbreak Strikes New Jersey Tomorrow, Are You Fully Prepared for the Nursing Consequences?

New Jersey Nurse, May/Jun 2004 by Torre, Carolyn

The Coalition of Nursing Interest Groups met at NJSNA headquarters in Trenton on the evening of April 27, 2004. Representatives of these groups were asked to bring examples of educational or skills programs which they have offered to their nursing constituents around the issue of Bioterrorism Preparedness during the past year and/or since 9/11/01. The following fifteen individuals representing their associations joined NJSNA President Mimi Cappelli, Linda Parry Carney, NJSNA President-Elect and NJSNA staff for a lively dinner discussion: Alice Slifko, Association of Diploma Schools of Professional Nursing; Ann Twomey, Health Professionals and Allied Employees AFT/AFL-CIO (HPAE); Carol Kientz, Home Care Association of New Jersey (NJHCA); Connie Wilson and Evelyn Thornton, LPN Association of New Jersey; Hannah Tracy, New Jersey Red Cross; Angela Richman, Margaret Burgoyne and Linda DeLamar, New Jersey Association of Nurse Anesthetists; Janice Vermeychuk, New Jersey College Health Association (NJCHA); Mary Suessmann and Margaret Bush, New Jersey State School Nurses Association (NJSSNA); Marianne Duffy, Organization of Nurse Executives (ONE), Anne Boyle, New Jersey Hospice Organization and Darlene Borromeo, Philippine Nurses Association of New Jersey, Inc.

Participants agreed that state and local governmental departments, institutions and agencies overall, seem to lack a recognition of the need to include nurses as key planners in bioterrorism preparedness. With rare exceptions, nurses have only come to the governmental planning table on this issue when they have asserted such a need on their own. There is no evidence that an on-going funding commitment has been made at the state or federal level to provide primary and continuing education for nurses around the issue of bioterrorism. This is a fundamental problem since nurses are the keystone to any care that is offered to any victims of bioterrorism in schools, in the hospital, in long-term care or in the home.

To fill what they see as an educational and planning gap, nurses have taken matters into their own hands and organized programs and tutorials for other nurses and worked, where they can, to make connections with state and local governmental agencies and departments so that they will be prepared should a incident of bioterrorism occur on their watch or in their work setting, immediate neighborhood or community. However, even where the efforts of nurses to prepare for bioterrorism are, and have been, very intensive, they are also more organization-specific than connected or interlinked.

Janice Vermeychuk described the February 2004 NJ College Health Association (NJCHA) seminar, "Critical Incident Planning and Emergency Management for College Campuses" attended by well over 50 nurses. NJCHA is encouraging all their members to attend a daylong "Infectious Disease Summit" which will be conducted at two locations by the NJ Department of Health and Senior Services in late May, 2004. Ms Vermeychuk pointed out that many college health nurses..."play a vital role in the Critical Incident Response Teams at their respective campuses and that in addition, many have been actively involved in writing the disaster plans for their campuses."

Ann Twomey discussed HPAE's support for members around the issue of smallpox vaccination. HPAE published a position statement and provided members with written materials to help them make informed choices about obtaining or declining the vaccine.

Mary Suessmann of NJSSNA clearly articulated the central role that school nurses will play in children's lives, should an incident of bioterrorism occur in the community. She underscored that all schools are already required by the Department of Education to have a Disaster Plan in place. However, each school currently has its own plan; the Department of Education's proposed template for best practices related to disaster planning has not yet emerged for use.

Ms Suessmann says that of NJSSNA's 1235 members (out of 2200 school nurses statewide), most, but not all have attended bioterrorism preparedness classes. She describes a need for regular, periodic education to keep knowledge on the issue, current. She pointed out that several counties, including Ocean, Burlington and Morris have cooperated with local schools to help provide stock supplies for Sheltering in Place. Ms. Suessmann expressed reservations, however, about the mixed abilities of individual schools to stockpile sufficient materiel and equipment for Sheltering in Place, should the need arise, since there is no overall direction from the state to ensure uniformity of preparation. About 60 school nurses attended a meeting this past week at Monmouth University around the issue of bioterrorism preparedness. During the past year, NJSSNA partnered with the New Jersey section of the American Academy of Pediatrics to conduct workshops for school nurses around bioterrorism-related rash recognition.

Carol Kientz, New Jersey Home Care Association, brought with her the Bioterrorism Preparedness Manual her association has developed for use in home care. The manual has been so useful and so popular that, with the association's blessing, it has been adopted in whole or in part by home care associations in other states seeking a similar guide. NJHCA meets monthly with a group of interested parties including representatives from the New Jersey Hospital Association and two Long Term Care Associations to discuss ongoing issues related to disaster and bioterrorism preparation. Ms Kientz commented that "nurses are kind of on their own out there..." because there is not much coordination from the standpoint of nursing care, either from the state level down or between different health care institutions/providers.